Provider Demographics
NPI:1831646371
Name:SARUBBI, JAIMIE (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:JAIMIE
Middle Name:
Last Name:SARUBBI
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MASTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11951-3120
Mailing Address - Country:US
Mailing Address - Phone:631-871-6278
Mailing Address - Fax:
Practice Address - Street 1:226 CHICHESTER AVE
Practice Address - Street 2:
Practice Address - City:CENTER MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11934-2000
Practice Address - Country:US
Practice Address - Phone:631-375-6003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001239103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst